Oct 30, 2020, 12:33:38 PM CDT Oct 30, 2020, 1:20:55 PM CDT

Separation anxiety in children

Tips to help ease your child’s fears during COVID-19

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Due to COVID-19, many children are spending more time at home with their parents. During this pandemic, kids have learned about the risks of being around large groups of people. They've followed new rules about wearing a mask, hand washing and social distancing. But now, as schools and activities resume, many children – even those who were once excited to go to school – feel intense separation anxiety about leaving their parents' side.

Sara Loftin, LPC, RPT, Clinical Therapist at Children's Health℠, explains what fuels separation anxiety and how you can help your child feel safe about going to school or daycare.

What is separation anxiety?

"Separation anxiety is a normal part of development for children. It typically develops by 8 to 12 months and usually ends for toddlers around ages 2 or 3," Loftin says. "It's most common with babies and toddlers but can also be experienced by teenagers transitioning to high school or those leaving for college."

"Kids typically feel safest with their primary caregivers," she says. When children experience separation anxiety, they have difficulty being apart from their primary caregivers; they may even want to be in the same room. Being separated causes feelings of worry, fear and anxiety.

In children under age 4, symptoms of separation anxiety may include:

  • Clinging to parents
  • Crying
  • Nightmares
  • Stomach aches
  • Throwing tantrums

School-aged children and teens may show symptoms of separation anxiety, such as:

  • Asking specific questions about how long a parent will be gone
  • Changes in behavior, such as acting out
  • Declining grades
  • Extreme resistance to going to school, including crying or screaming
  • Fear of a parent's death
  • Headaches or stomach aches, even hours before the separation occurs
  • Increased irritability and mood swings
  • Losing interest in things they love
  • Nightmares or sleep disturbances
  • School-aged children may regress to younger behavior, such as wanting to sleep in their parents' bed or having toileting accidents
  • Trouble concentrating

What triggers separation anxiety in kids?

"While separation anxiety is uncommon among older kids, we are currently living in uncommon times," Loftin says. It makes sense that many children are worried and anxious about returning to school.

"I saw an increase in anxiety in children during the pandemic," Loftin says, "but I see more children with separation anxiety now that children are trying to return to normal routines."

Back-to-school jitters are normal, but today, children can feel a heightened anxiety level because they've been told to stay away from others. Now some kids are going to school in person and may not feel safe. They also may not understand what COVID-19 is and what the risks are.

Even during normal times, changes can trigger separation anxiety. Common triggers of separation anxiety include:

  • Change in environment, such as moving to a new place or attending a new school
  • Change in schedule or routine, such as starting school or going on vacation
  • Changes in health, such as becoming ill or injured

"When you know small things can trigger separation anxiety and then experience a global pandemic, it makes sense that some children may feel so much anxiety now," Loftin says.

How to ease separation anxiety in kids

The key to overcoming separation anxiety is helping your child feel safe. Talk to them about how you are staying safe and how the school is keeping them safe. Let them know how school may be different now and why those differences are good.

  1. Allow your child to ask questions, even if you don't have all the answers. And remember to be honest. Honesty builds trust.
  2. Follow through with what you say to your child. If you tell your child you'll be back in 10 minutes, make sure you are. If you are tempted to let your child stay home from school when they are upset, don't. Giving in may make the separation anxiety worse in the future.
  3. Practice separation. Try leaving for short periods – take a walk around the block. Practice routine separation and remain calm throughout. If you feel anxious, your child can tell and will also feel anxious.
  4. Create rituals and routines. Create separation rituals, such as a goodbye hug or giving them a separation item like a stuffed toy or sticker. Having this routine can help your child feel positive and safe about the separation. Sticking to routines throughout the day help children predict what will happen.

"Children feel safe when there is a predictable and structured environment with limits," Loftin says. While structure is important, so is some choice. Presenting children with simple choices, such as which cup to use or what outfit to wear, can help them feel more independent and empowered. Independent children have fewer struggles with separation anxiety.

When should parents worry or visit a doctor due to separation anxiety?

Separation anxiety can be normal and may be temporary. If it begins to affect your child's ability to perform normal tasks, talk to your child's doctor.

"When anxiety is impacting your child's school attendance or your work attendance as a parent, that's a red flag," Loftin says.

Prolonged symptoms, especially symptoms like regressing to younger behaviors, difficulty sleeping or experiencing headaches and stomach aches, may also indicate that your child should see a physician.

"There are lots of different ways to help a child with separation anxiety," Loftin says. "Play therapy can be helpful for younger children, and Child-Parent Relationship Training can enhance the connection between child and parent to help them feel safe, too."

Learn more

Children's Health is committed to remaining a trusted source of health information and care for you and your family during this time. See more resources to keep your family healthy at the Children's Health COVID-19 hub.

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coronavirus, anxiety, behavior, mental health, stress

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